Provider Demographics
NPI:1942972567
Name:CUEVAS, JENNY
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:CUEVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JENNY CUEVAS
Mailing Address - Street 1:4895 PASTEL LN
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-7581
Mailing Address - Country:US
Mailing Address - Phone:323-245-4300
Mailing Address - Fax:
Practice Address - Street 1:1085 W BADILLO ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91722-4112
Practice Address - Country:US
Practice Address - Phone:332-626-8138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator